The Comprehensive Cancer Center of Wake Forest University and its affiliated CCOPs ([1] Southeast Cancer Control Consortium; [2] Spartanburg Community Clinical Oncology Program) will further utilize its oncology "community leader model" for both the development and implementation of its cancer control program. This model utilizes a lead CCOP community oncologist who identifies, contacts, and recruits local physicians to participate in cancer control studies. The adenomatous polyp prevention trial and state-of-the-art cancer management in rural areas research project have provided this Comprehensive Cancer Center with extensive experience in performing cancer control research in CCOP communities. The two protocols approved for CCOP usage entitled (1) Improving Follow-up Among Women with Abnormal Pap Smears; and (2) The Quality of Life Assessment of Women Greater than Sixty-Five Years of Age Receiving Mitoxantrone vs. CMF will utilize this community model. The Research Base will proceed with the development of concepts as follows: (1) smoking cessation among pregnant adolescents; (2) an educational program in breast cancer screening for asymptomatic sisters and daughters of breast patients; (3) promoting community cancer control activities; and (4) quality of life in women taking tamoxifen or high dose megestrol acetate for advanced breast cancer. Other concepts that are under development with this grant application are: (1) the role of vitamin E in breast cancer prevention; (2) colon cancer prevention in relatives of colon cancer patients; (3) screening for prostate cancer among relatives of prostate cancer patients; (4) screening for ovarian cancer among high risk individuals; (5) breast cancer care in older women; (6) ondansetron dose reduction study; and (7) response to anti-elliptic drugs in patients with cancer related neurogenic pain. The cancer treatment clinical trials program will continue to provide an excellent source of research protocols for its affiliated CCOPs. Our program of experimental therapeutics in the division of basic sciences will expand our pharmacokinetic potential, and our affiliation with the National Cancer Institute in conducting a suramin trial for prostate cancer provides a strong base for new drug development which can utilize the treatment resources of the affiliated CCOPs. An example of our potential for phase III studies is a newly activated breast cancer protocol which will evaluate mitoxantrone vs. CMF in women greater than 65 years of age. This protocol is specifically designed to explore quality of life issues related to treatment. The re-organization of the biostatistical core and data management component of the research base has been extensive. Administratively, this unit is under the Department of Public Health Sciences and provides unique autonomy for this unit within the Cancer Center program. This research base application documents the effectiveness of this unit in collecting and evaluating both cancer treatment and cancer prevention and control research data. The Comprehensive Cancer Center of Wake Forest University has undergone extensive extramural review since February 1991 and the advice of its reviewers have been incorporated into this research base application.